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Non-Small Cell Lung CancerImmuEXNCT07267000

EXERCISE AND THE IMMUNE RESPONSE IN LUNG CANCER

A study testing Exercise in people with Non-Small Cell Lung Cancer and Exercise Training, run by Medical University of Graz at 1 site in Austria.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This project is about the effect of a 12-week training therapy intervention in patients suffering from non-small cell and small-cell lung cancer. It has widely been accepted that exercise is preventive against certain types of cancer. Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteAustria
Study dates
1 Apr 2026to 1 May 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients suffering from non-small cell or small-cell lung cancer of any histologic subtype, irrespective of routine treatment regimen
  • ECOG 0 or 1

Who cannot join

  • Kachexia (BMI<18.5)
  • instable bone metastases
  • orthopedic condition rendering the patient unable to ride a stationary bike
  • any medical contraindication for exercise and training
  • a living will against basic or advanced life support

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Lukas Spielbüchler, MEd, BEd contact

+43 699 10558825

lukas.spielbuechler@medunigraz.at

Emine Betül Deniz, MSc contact

+43 676 4029105

emine.deniz@medunigraz.at

Austria1 site, 1 recruiting
  • Medical University of Graz

    Graz, 8010

    Elisabeth Taucher, Dr. Dr., +43 6648438876, elisabeth.taucher@medunigraz.at

    Nikolaus Kneidinger, Prof. Dr., +43 316 385 12183, nikolaus.kneidinger@medunigraz.at

    Recruiting

Other trials in Austria

About this study

This project is about the effect of a 12-week training therapy intervention in patients suffering from non-small cell and small-cell lung cancer. It has widely been accepted that exercise is preventive against certain types of cancer. Individuals following an active lifestyle have a significantly lower risk for several chronic diseases, including cancer, as compared to sedentary ones. However, evidence is still lacking for exercise as part of routine cancer treatment. It has widely been accepted that exercise strongly impacts immune response, and might influence antitumor immune response as well. In this study, patients suffering from lung cancer undergo either a 12-week training program consisting of moderate-intensity continuous exercise (MICE), or a 12-week program with high-intensity interval exercise. Both groups will be compared to a control group receiving standard exercise recommendations. The immunologic response, i.e. cytokine profiles and changes in peripheral blood mononuclear cell (PBMC) characteristics will be the main endpoint. Blood will be taken from the patients at different timepoints, and blood samples will be tested for these immunologic changes. FACS analysis will be used to assess the properties of immune cells and potential changes upon the exercise regimen. Mitochondrial function will be assessed via the Seahorse machine, and mass spectrometry (lipidomics) will be used for the analysis of lipid profile changes.

Read the detailed description

Lung cancer is the number one cause of cancer-related deaths worldwide. A few decades ago, the prognosis at lung cancer first diagnosis was generally poor with only a few months of median survival. New treatment regimens have markedly improved survival times - especially in certain histologic and molecular pathologic subtypes. The positive effect of exercise on the incidence of several cancer entities such as colorectal- or breast cancer, has been demonstrated previously. Physically active individuals are diagnosed with cancer significantly less often as compared to sedentary people. In oncologic follow-up care, a positive effect of exercise and training with an advantage in survival has also been proven, e.g. in breast cancer patients.

In addition, existing data shows a positive effect of exercise on the immune system: active individuals show a different pattern of proinflammatory markers in the blood serum, with every exercise session generating an immune-stimulatory effect which changes the immunologic serum profile also at rest. Thus, regular exercise has an anti-inflammatory long-term effect.

Hypothesis and Objectives: With this project the investigators seek to demonstrate distinct immunologic changes, assessing cytokine serum profiles and changes in peripheral blood mononuclear cell (PBMC) characteristics upon a medically guided training regimen. The investigators assume that the antitumor immune response is positively affected by the training therapy regimen.

Setting and Methods. To exactly define "exercise" in this setting, as a first step the investigators will test two exercise types in healthy individuals. According to the individual exercise capacity as determined by spiroergometry, healthy subjects will either perform moderate-intensity continuous exercise (MICE), or a high-intensity interval training (HIIT). By means of venous blood sampling before and after training the investigators determine the respective changes of serum immune markers through exercise. The same two training types will then be performed by lung cancer patients upon immunotherapy, with one patient group doing MICE-sessions, one group doing the HIIT and a third group who will receive general exercise recommendations but otherwise will not undergo supervised training. Inflammatory serum parameters and PBMC characteristics will be compared between the groups. Moreover, the overall aerobic capacity (and respective changes before and after the training intervention), as well as quality of life will be analysed.

Patients in the exercise groups will be advised to train once a week under medical supervision, and to walk briskly for 30 minutes every day of the week in addition. The investigators' hypothesis is, that exercise should be implemented as a complementary treatment strategy in the lung cancer treatment setting, possibly improving not only physical health and wellbeing but also treatment response. In addition to improving the patients' quality of life by a better physical capacity and fitness, helping the participants in everyday activities, the investigators propose that the implementation of exercise programs in various oncologic settings in future may improve the patients' outcome.

Scientific Novelty. Standardization of exercise regimens in oncologic scenarios in the existing literature is generally poor. The investigators carry out one of the few studies where the type, duration, timing and intensity of exercise in both exercise groups is clearly defined according to the F.I.T.T. (frequency, intensity, type, time)-principle, comparing two different training modalities to sedentary control patients, respectively. Exercise needs to be seen as a drug, and like in any drug the optimum dose must be clearly outlined.

Being tested
Exercise, Control
Keywords
Non-small cell lung cancer, Exercise, Immunotherapy, Outcome, Small-cell lung cancer
Medical subject headings
Carcinoma, Non-Small-Cell Lung, Small Cell Lung Carcinoma, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ExerciseBehavioural

    Also called Home-based walking exercise

    1 study arm doing continuous type exercise will be compared to 1 study arm doing high-intensity interval exercise, over the course of 12 weeks, respectively. Both arms will be compared to sedentary control patients.

  • ControlOther

    For patients in the control group, general exercise recommendations (e.g. recommendations by the CDC suitable for all adult individuals) will be given, however, no training therapy intervention is done and no home-based walking exercise is required either.

Study groups in NCT07267000
Study groupRoleWhat they receive
Continuous ExerciseExperimentalPatients in this arm will undergo a 12-week training therapy regimen consisting of twice weekly supervised moderate-intensity continuous exercise (MICE) and home-based walking exercise for 30 minutes, five times a week, in addition.
Receives: Behavioral: Exercise
High Intensity Interval ExerciseExperimentalPatients in this arm will undergo a 12-week training therapy regimen consisting of twice weekly supervised high-intensity interval exercise and home-based walking exercise for 30 minutes, five times a week, in addition.
Receives: Behavioral: Exercise
ControlsActive comparatorPatients in this arm will receive general recommendations on an active lifestyle, but will not take part in supervised training sessions and are not asked to do home-based exercise either.
Receives: Other: Control

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. FACS analysis of PBMCs

    The FACS panel comprises:

    CD4pos Helper T Cells, CD8pos Cytotoxic T Cells, Regulatory T Cells, Effector Memory T Cells, Naive/Memory Subsets, Activated/Exhausted T Cells, gamma-delta T Cells, Naive B Cells, Memory B Cells, Transitional B Cells, Classical Monocytes, Intermediate Monocytes, Non Classical Monocytes, NK CD16pos, NK CD16neg, Neutrophils, Basophils, Mast Cells, Viable vs. Dead Cells, Immune Checkpoint Subsets, Activation/Proliferation Markers.

    The total numbers and percentages of cells positive for the above listed markers are the primary outcome measures.

    The surface marker profile of PBMCs as a whole will define the outcome, showing differences between exercising and sedentary patients, e.g.: "In patients from the exercise group, XX% of naive B cells were found, and XX% of CD4pos Helper T Cells, and XX% CD8pos Cytotoxic T Cells were found. In patients from the control group, the proportion of naive B cells was XX...".

    Measured: Before and after the 12 week training therapy intervention, i.e. differences seen between 12 and 14 weeks

Secondary outcomes (7)
  1. Cytokine analysis from peripheral blood sampling

    IFN gamma, IL-13, GM-CSF, IL-1β, IL-5, sCD25 (IL-2Ra), IL-4, VEGF, IL-17A, IL-18, CCL4 (MIP-1β), IL-15, IL-12p70. The count of the above listed cytokines in pg/ml will be recorded in venous blood samples, with higher values after exercise indicating a more pronounced inflammatory response.

    Blood plasma samples from the patients will be collected at the beginning and after the 12 weeks exercise intervention for cytokine testing. Additionally, cytokine profiling will be done before and after one exercise bout to illustrate acute changes. Multiplex detecton kits (Legendplex) will be used for cytokine profiling.

    For every cytokine, differences will be recorded in one patient at enrollment and after completion of the 12 week training therapy. Differences between the exercising and non-exercising patients will be recorded as well. E.g. "IFNgamma levels were on average XX pg/ml before the intervention. After the intervention period of 12 weeks, IFNgamma levels were on average XX pg/ml."

    Measured: From enrollment to after the 12 week intervention, i.e. a period between 12-14 weeks

  2. Number of participants with changes in mitochondrial function (Seahorse analysis)

    Mitochondrial function parameters are combined to assess how well mitochondria work in a given patient.

    Oxygen Consumption Rate (OCR), Extracellular Acidification Rate (ECAR), Glycolytic Rate, Glycolytic Capacity, Basal Oxygen Consumption Rate, Maximal Respiration, and Spare Respiratory Rapacity are assessed by means of a Seahorse assay using a Seahorse XF Analyzer from Agilent, that measures the real-time metabolic activity of live cells by simultaneously assessing mitochondrial respiration and glycolysis. The number of patients with changes in oxygen consumption rate (OCR), which indicates mitochondrial respiration, and the extracellular acidification rate (ECAR), which is linked to glycolysis, is analysed. Aberrations in mitochondrial function as well as changes from before to after the intervention in % of patients / total number of patients is assessed.

    Measured: From enrollment to after completion of the exercise intervention, i.e. a period between 12-14 weeks

  3. Mass spectrometry - Lipidomics

    Marker Name (or m/z value), Retention Time and Intensity/Abundance of a given metabolite will be analysed in plasma samples. Markers comprise H4CH, H4A1, H4A2, TPA1, HDA1, IDPL, H4PL, Glutamine, L5CH, H3CH, TPA2, HDA2, L5PL, HDCH, H3A2, TPCH, L5PN, L5AB, V1FC, H3FC, L5FC, SPC, IDTG, V5FC, Glutamic acid, H4FC, Alanine, HDPL, V2PL, Glucose, LDCH, L4CH, H3A1, L4FC, V2TG. Lipidomics is used to describe the complete lipid profile within the patients' immune cells. It is a subset of the "metabolome". As opposed to classic analysis of carbohydrate metabolism, lipids are more stable, allowing for an analysis of frozen PBMCs. Our hypothesis is that upon the exercise program, lipidomics of the immune cells significantly change, allowing for a more favorable antitumor immune response. Total counts of each above-listed metabolite in the blood will be determined, e.g. in milligrams per deciliter and for every metabolite, changes between exercising and sedentary patients are recorded.

    Measured: From enrollment to after completion of the 12 week exercise intervention, i.e. a time period between 12 and 14 weeks

  4. Aerobic capacity

    With spiroergometry testing at the beginning of the exercise program and after completion of the program at 12 weeks, the investigators will assess potential changes in the patients' aerobic capacity.

    The normal range for womens' VO2max starts at 30 ml/kg/min and for men at 35 ml/kg/min with lower ranges expected in the usually elderly tumor patients. Improvements over the 12 week intervention period will be recorded.

    Measured: From enrollment to after completion of the 12 week training therapy intervention, i.e. a time period between 12 and 14 weeks

  5. Quality of life - EORTC-QLQ C30 (German version)

    The patient's quality of life will be assessed by two questionnaires, one for quality of life in cancer patients in general and one questionnaire specifically for lung cancer.

    The EORTC-QLQ C30 (German version) has a range from 0-100 with higher values representing a better quality of life. Minimal Important Difference (MID): A change of 5 to 10 points is generally considered clinically meaningful.

    Differences of 10 points are often used to indicate clinical relevance.

    Measured: From enrollment to after completion of the 12 week training therapy intervention, i.e. a period between 12 and 14 weeks

  6. Quality of life - FACT-L scale (German version)

    The FACT-L (Functional Assessment of Cancer Therapy-Lung) questionnaire has a maximum possible total score of 0 to 136, which includes the 27-item FACT-G (general) and the 9-item Lung Cancer Subscale (LCS). Higher scores indicate better quality of life.

    Measured: From enrollment to after 12 weeks, i.e. a period between 12 and 14 weeks

  7. Bodycomposition / Bioimpedance measurement

    Bioimpedance measurement will be used to determine body composition (and possible increments in muscle mass). The measures are given in % of total body mass. Higher values of muscle mass are generally considered better and indicate a good response to training, whist declines in muscle mass are often observed in inactive cancer patients.

    Measured: Enrollment to after 12 weeks, i.e. a period between 12 and 14 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2025
  2. Study start1 Apr 2026
  3. Primary completion1 Oct 2028 (estimated)
  4. Study completion1 May 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07267000
Sponsor's protocol ID
ImmuEX
Other IDs
PAT1625724
Acronym
ImmuEX
Status last verified
Nov 2025
First submitted
24 Nov 2025
Last updated
9 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: It depends on the data that is measured, especially as far as the basic research experiments (FACS, Seahorse, Cytokines, Lipidomics) are concerned. If the data is promising, we might share it with other researchers for additional publication.

Publications

  • Martin-Ruiz A, Fiuza-Luces C, Rincon-Castanedo C, Fernandez-Moreno D, Galvez BG, Martinez-Martinez E, Martin-Acosta P, Coronado MJ, Franco-Luzon L, Gonzalez-Murillo A, Ramirez M, Provencio M, Lucia A. Benefits of exercise and immunotherapy in a murine model of human non-small-cell lung carcinoma. Exerc Immunol Rev. 2020;26:100-115.

    PubMed 32139351
  • Ungvari Z, Fekete M, Varga P, Munkacsy G, Fekete JT, Lehoczki A, Buda A, Kiss C, Ungvari A, Gyorffy B. Exercise and survival benefit in cancer patients: evidence from a comprehensive meta-analysis. Geroscience. 2025 Jun;47(3):5235-5255. doi: 10.1007/s11357-025-01647-0. Epub 2025 Apr 12.

    PubMed 40220151
  • Winters-Stone KM, Neil SE, Campbell KL. Attention to principles of exercise training: a review of exercise studies for survivors of cancers other than breast. Br J Sports Med. 2014 Jun;48(12):987-95. doi: 10.1136/bjsports-2012-091732. Epub 2013 Jan 4.

    PubMed 23293010
  • Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116.

    PubMed 31626055
  • Rezende LFM, Sa TH, Markozannes G, Rey-Lopez JP, Lee IM, Tsilidis KK, Ioannidis JPA, Eluf-Neto J. Physical activity and cancer: an umbrella review of the literature including 22 major anatomical sites and 770 000 cancer cases. Br J Sports Med. 2018 Jul;52(13):826-833. doi: 10.1136/bjsports-2017-098391. Epub 2017 Nov 16.

    PubMed 29146752
  • Ashcraft KA, Peace RM, Betof AS, Dewhirst MW, Jones LW. Efficacy and Mechanisms of Aerobic Exercise on Cancer Initiation, Progression, and Metastasis: A Critical Systematic Review of In Vivo Preclinical Data. Cancer Res. 2016 Jul 15;76(14):4032-50. doi: 10.1158/0008-5472.CAN-16-0887. Epub 2016 Jul 5.

    PubMed 27381680

Questions about this trial

What is this clinical trial studying?

A study testing Exercise in people with Non-Small Cell Lung Cancer and Exercise Training, run by Medical University of Graz at 1 site in Austria.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 9 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Austria. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Lukas Spielbüchler, MEd, BEd (+43 699 10558825, lukas.spielbuechler@medunigraz.at), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

FACS analysis of PBMCs (time frame: Before and after the 12 week training therapy intervention, i.e. differences seen between 12 and 14 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07267000, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jun 2026.

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